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NPI Code Detail

MEDICARE: DR. EMILY BRADHAM PHARM.D.

MEDICARE: DR. EMILY BRADHAM PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist24209NC

General Provider Information

NPI Number : 1689074940
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY BRADHAM PHARM.D.
Provider Business Mailing Address
First Line : 600 CEDAR CREEK RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28312-6504
Country : US
Telephone Number : 910-483-8972
Fax Number : 910-484-0607
Provider Business Practice Location Address
First Line : 600 CEDAR CREEK RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28312-6504
Country : US
Telephone Number : 910-483-8972
Fax Number : 910-484-0607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2014
Last Update Date : 08/23/2014

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